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Viral pneumonia in kids?

Most people don’t realize it, but this disease is one of the leading killers of children under the age of five around the world.  People often think of malaria, diarrhea, birth asphyxia, or preterm birth complications as early childhood killers.  And they are. But so is viral pneumonia, often caused by the respiratory syncytial virus (RSV).

“Of the more than 30 million childhood cases worldwide, RSV causes 1.4 million hospitalizations in the first 6 months of life and 120,000 deaths before five years of age worldwide each year. Severe complications include pneumonia and bronchiolitis.” 1

The problem with this disease is that it’s not always easy to diagnose. In many cases, doctors will use antibiotics, thinking that the problem is bacterial. But a recent study has shown that about 60 per cent of the cases were caused by a virus, while 20 percent were caused by bacteria, and the rest fungi, tuberculosis, and other unknown sources.

RSV is, itself, fairly common, infecting most children by the time they are two years old, though RSV can infect adults as well. In most cases the symptoms are fairly mild, and often mimic a cold: congestion, runny nose, cough, sore throat, fever, headache.  The common stuff to alleviate the hassles of a cold can help here, and usually within a week or so the child is fine.

However, in severe cases, the infection can spread to the lower respiratory tract. If this happens, it can cause pneumonia, which can be very dangerous. Signs and symptoms may include fever, a very severe cough, wheezing, difficulty breathing, and even cyanosis, when the skin turns blue due to lack of oxygen.  In developed countries, like the United States, though the death rate from this infection is much lower than in other countries, RSV caused pneumonia is still one of the leading causes of child hospitalization.

RSV can enter the body through the mouth, nose, or even eyes. It is an airborne virus as well; that is, someone with the RSV bug can pass it to you or your toddler by coughing or sneezing.  Adults can also pass it with handshakes. RSV can exist for hours on tables, chairs, countertops, toys and crib rails, which means that someone (including a toddler) who touches his or her eyes, nose, or mouth after coming in contact with a contaminated surface can get sick.  Those at the most severe risk of a life-threatening case of pneumonia caused by RSV are premature infants, toddlers with congenital heart or lung disease, children with weakened immune systems, and infants in crowded childcare settings.

Clearly RSV is something that must be reckoned with, which is why there has been a drive, for a long time, among medical researchers to come up with a vaccine to protect against this dangerous foe.  Unfortunately, nothing has been produced deemed good enough yet to release to the general public, despite people working hard on it.

In 1967, infants and toddlers who had been immunized with a formalin-inactivated vaccine against RSV became infected with wild-type virus in the community. Hospitalizations were frequent, and two immunized toddlers died after being infected with the wild-type RSV and developing what, after decades of research, is now known as enhanced RSV disease (ERD).

“The world of RSV vaccines,” wrote Polack, Acosta, and Caballer, “is experiencing important changes. In recent years, epidemiological studies highlighted the burden of RSV disease worldwide stressing the public health need for vaccine development against the pathogen…In addition, a variety of novel approaches to vaccination have emerged which may present individual characteristics that theoretically affect the risk for ERD.”2

Meanwhile the World Health Organization has made finding a vaccine for RSV a priority.

“The World Health Organization (WHO) Product Development for Vaccines Advisory Committee (PDVAC) considers it a priority to ensure that emerging RSV vaccines are suitable for licensure and meet policy decision-making needs to support optimal use in low- and middle-income countries in addition to high-income countries.”3

No question, viral pneumonia in kids is a deadly problem that needs to be addressed, especially in parts of the world deemed extremely poor (people living on less than one dollar per day). Here, too, is where most of those who get the disease, toddlers especially, often die. This is why ongoing research is so vital, and though some have said that we reached the “golden age” of RSV vaccine research, nothing will be golden until a safe vaccine is found.